罕见巨大阔韧带浆液性囊腺瘤1例报告及文献复习

目的：探讨1例罕见巨大阔韧带浆液性囊腺瘤患者的临床资料和手术经过，阐明巨大阔韧带浆液性囊腺瘤的诊断及手术治疗要点，探讨腹腔镜在阔韧带肿瘤手术中的应用现状及优势。方法：患者因腹胀2年，加重2个月入院，结合术前彩超及查体诊断为盆腹腔肿物，考虑卵巢来源。剖腹探查术中所见及术中快速病理明确诊断为巨大阔韧带浆液性囊腺瘤，手术操作时仔细辨认输尿管位置及子宫动静脉，并于肿物基底部结扎止血，手术过程顺利。结果：巨大阔韧带浆液性囊腺瘤超声表现与巨大卵巢肿瘤相似，超声误诊率高，CT和MRI对于鉴别巨大阔韧带肿瘤有重要意义，可提高术前诊断准确率；术中操作时应紧靠肿瘤表面仔细钝性分离，避免损伤输尿管，该例患者恢复良好出院。结论：巨大阔韧带浆液性囊腺瘤患者缺乏特异性表现，应结合患者病史及影像学表现提高术前诊断准确率。应选择合理的手术方案，术中操作精细以避免副损伤的发生。

Rare huge serous cystadenoma of broad ligament: A case report and literature review

Objective: To analyze the clinical data and surgical treatment procedures of a patient with rare huge serous cystadenoma of broad ligament,to clarify its diagnostic and treatment characteristics,and to explore the present situation and advantages of laparoscope in the operation of broad ligament tumor. Methods: The patient was admitted to hospital due to abdominal distension for 2 years and aggravated illness for 2 months.The diagnosis result was pelvic and abdominal mass arising from ovarian according to the preoperative color Doppler ultrasound and physical examination.Based on the laparotomy and intraoperative rapid pathological results,the patient was diagnosed as huge serous cystadenoma of broad ligament.The location of ureter and uteri artery and vein were carefully identified during the operation and they were ligated for hemostasis at the basal part of tumor.The operation was successful. Results: The ultrasonography image of the huge serous cystadenoma of broad ligament was very similar to that of large ovarian tumor.The misdiagnosis rate of ultrasound was high,and CT and MRI were important for the identification of large broad ligament tumor;the accuracy rate of preoperative diagnosis could be improved by CT and MRI.Carefully blunt separation close to the tumor surface during the operation could avoid the ureteral injury.The patient recovered well and discharged from hospital. Conclusion: The symptoms of huge serous cystadenoma of broad ligament patient are lack of specificity.The accuracy rate of preoperative diagnosis should be improved in combination with the medical history and imageological findings of the patient.The operation plan should be chosen reasonably and the operation should be carefully performed to avoid the occurrence of secondary injuries.